Original Research Article
Year: 2014 | Month: July | Volume: 1 | Issue: 1 | Pages: 48-52
Effect of Core
Stability Exercises in Treatment of Non Specific Low Back Pain in Young Adults
Gauri
Shankar1, Yama Joshi2
1Research
Scholar, Singhania University, Pachheri Bari, Rajasthan, India.
2MPT,
Physiotherapist, Gujarat, India.
Corresponding
Author: Gauri Shankar
ABSTRACT
Background: People suffer
with low back pain due to reduced physical activity. Epidemiological studies
indicate that about 60-80% of the general
population suffer low back pain at some point in their lives.
Methodology: 52 young adults
participated in this study based on convenient sampling method. Participants
were allotted in two groups: group A (Experimental group- Core stability exercises)
and group B (Control group- conventional exercises & back care advice). All
the exercises were demonstrated to the participants for both the groups and all
the treatment sessions were carried out alternatively thrice a week for 3 weeks
under the observation. After completing treatment protocol of 3 weeks,
participants were again given Functional Pain Scale and Modified Oswestry Low
Back Pain Disability Questionnaire to check the difference in pain and
disability due to low back pain following the exercise protocol.
Results: In experimental group post
MOSW reduced from 20% to 8.63% after core stability exercises while in control
group post MOSW reduced from 17.57% to 14.42%. Post functional pain scale (FPS)
reduced in both group. After treatment session, MOSW reduced in experimental
group (8.63%) than control group (14.42%) while FPS score was less in
experimental group (15.61) in comparison to control group (23.39).
Conclusion: Core stability
exercises are effective in reducing pain and improving functional disability
among young adults with non specific low back pain.
Key words:
Core, Core
stability exercise, Non-specific low back pain.
INTRODUCTION
In today’s
advanced technology era people prefer to use technology induced luxuries
instead of doing physical work. Relative reduced physical activity results in
many discomforts like low back pain. Epidemiological studies indicate that
about 60-80% of the general population suffer low back pain
at some point in their lives.[1]
Non-specific low back pain is defined as low back pain
not attributable to a recognisable, known specific pathology (e.g., infection,
tumour, osteoporosis, fracture, structural deformity, inflammatory disorder,
radicular syndrome, or cauda equina syndrome). [2]
Endurance of
lumbar stabilizer is most important key for preventing lumbar pain. [3,4]Trunk muscle endurance training has
been recommended as means of increasing fatigue threshold and improving
performance and reducing disability.[5]Improving endurance of
trunk extensor therefore appears to be sound and promising approach for
preventing low back pain and hence justification for conducting this study
among individual without low back pain.
The core can be described as a muscular box with the
abdominals in the front, paraspinal and gluteals in the back, the diaphragm as
the roof, and the pelvic floor and hip girdle musculature as the bottom.[6] The
core is also commonly referred to as the “power house” or the foundation of all
limb movements.[7]
Objectives:
·
To study the effect of core stability exercises in relieving pain and
improving functional disability in
college going students with non specific
low back pain.
·
To study the effect of conventional physiotherapy in relieving pain and
improving functional disability in college going students with non specific low
back pain.
·
To compare the effect of core stability and conventional physiotherapy
in treatment of non specific low back pain among college going students.
Hypothesis
Null Hypothesis: There will be no significant effect of core stability
exercises in relieving pain and improving functional disability in treatment of
non specific low back pain.
Study Design: Experimental
study
Source of Data: 52 healthy
young adults.
Sampling Design: Convenient
sampling
Inclusion Criteria
·
Age group: 18 – 25 years
·
Self reported healthy students having non-specific low back pain
Exclusion Criteria
·
History of trauma
·
Thoracic pain
·
Past medical history of malignant tumour
·
Prolonged use of corticosteroids
·
Drug abuse, immunosuppression, HIV
·
Any systemic disease
·
Unexplained weight loss
·
Any neurological diseases
·
Structural deformity
·
Fever
Outcome Measures:
·
Functional Pain Scale
·
Modified Oswestry Low Back Pain Disability Questionnaire
Procedure
After distribution of questionnaire the participants
having back pain were assessed according to the assessment format. These
participants were approached and explained about the study and those willing to
participate were included in the study after taking a written informed consent
from the participant.
Before initiating the treatment participants were
given Functional Pain Scale to identify the level of pain and Modified Oswestry
Low Back Pain Disability Questionnaire to identify disability due to low back
pain.
Group A: Core stability exercises
Group B: Conventional exercises and back care advice
All the exercises were demonstrated to the
participants for both the groups and all the treatment sessions were carried
out alternatively thrice a week for 3 weeks under the observation.
After completing treatment protocol of 3 weeks participants were again
given Functional Pain Scale and Modified Oswestry Low Back Pain Disability
Questionnaire to check the difference in pain and disability due to low back
pain following the exercise protocol.
RESULT
Figure 1: Comparison of pre
MOSW and post MOSW in Experimental and control Group done with Paired t test.
Figure 2: Comparison of pre
FPS and post FPS in Experimental and control Group done with Wilcoxon Signed
Ranks Test.
Figure 3: Comparison of MOSW
between experimental group and control group done with Independent t test.
Figure 4: Comparison of FPS
between experimental group and control group done with Mann- Whitney U test.
The purpose of this study was to evaluate the effects
of core stability exercises in young adults with non specific low back pain.
Our data support the hypothesis that core stability
exercises reduces pain and disability, after 3 weeks of exercises.
The strength of the lumbar muscles is the key to the
stability of the lumbar region. Therefore, lumbar stability based on the
strength of the lumbar muscles is required to prevent lower back pain.[8]
Two studies on
low back pain shown significant reduction in pain and disability after core
stability exercise but no improvement in non treatment group.[9-13]
In our study there is significant improvement seen in
reducing pain (p≤0.05) and functional disability (p≤0.05) post
exercise from the pre exercise value in both experimental group and control
group.
In our study extensor endurance was taken before
starting the exercise protocol and after 3 week which shows significant
improvement after exercise. So that core stability exercise is also beneficial
in improving extensor endurance.
Some study[14] showed that both active trunk
extension endurance exercise and core stabilization exercise are effective in
improving endurance. Core stabilization exercises didn’t show any significant
over a trunk extensor endurance training protocol in improving endurance of
trunk extensors. Gauri Shankar et. al.[15]in another study on core stability
training showed that core
stabilization exercises with Swiss ball and without Swiss ball are equally
effective in improving trunk endurance.
Other studies[16-18]on core stability training were
done for more than 4 weeks while in our study the core stabilization-training began to show a difference on pain and
functional disability at three weeks with the improvement in extensor
endurance.
Here in this
study both core stability exercise and conventional physiotherapy are equally
effective in improving pain and disability. Core stability exercises do not
appear to provide additional benefit to patients with non specific low back
pain in comparison to conventional physiotherapy, as both the groups got
similar improvement.
There was
improvement in both groups, core stability exercise and even conventional
physiotherapy. There is statistical significance in core stability exercise
group which shows that core stability exercises are effective in reducing pain
and improving functional disability among young adults with non specific low
back pain.
REFERENCES
1.
Liebenson, Craig, Rehabilitation of the spine. Lippincott Williams and
Wilkins. 1996.
3.
Mayer T, Gatchel R, Betancur J,
et al. Trunk muscle endurance measurement. Spine 1995; 20:920–7.
7.
Akuthota, V. Core strengthening. Arch. Phys. Med. Rehab. 85 (3 supl):S86
– S92.2004.
10.
Hides JA, Richardson CA, Jull GA. Multifidus muscle
recovery is not automatic after resolution of acute, firstepisode low back
pain. Spine 1996; 21(23):2763– 9.
11.
Hides JA, Stokes MJ, Saide M, Jull GA, Cooper DH.
Evidence of lumbar multifidus muscle wasting ipsilateral to symptoms in
patients with acute/subacute low back pain. Spine 1994; 19:165–77.
12.
Hides JA, Richardson CA, Jull GA. Multifidus muscle
recovery is not automatic after resolution of acute, firstepisode low back
pain. Spine 1996;21(23):2763– 9.
17.
Swaney MR, Hess RA. The effects of core stabilization
on balance and posture in female collegiate swimmers. J Athl Train. 2003;
38S:S-95.
How to cite this article: Shankar G, Joshi
Y. Effect of core stability exercises
in treatment of non specific low back pain in young adults. Int J Res Rev.
2014; 1(1):48-52.
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